High-throughput gadobutrol-enhanced CMR: a time and dose optimization study

Journal of Cardiovascular Magnetic Resonance

Research

Silvio Mazziotti¹  Alfredo Blandino¹  Tommaso D’Angelo²  Konstantinos Bratis³  Chrysanthos Grigoratos⁴  Faraz Pathan⁵  Elen Elen⁶  Valentina O. Puntmann⁷  Eike Nagel⁷ 

[1] Department of Biomedical Sciences and Morphological and Functional Imaging, G. Martino University Hospital Messina, Via Consolare Valeria, 1, 98100, Messina, Italy;Department of Biomedical Sciences and Morphological and Functional Imaging, G. Martino University Hospital Messina, Via Consolare Valeria, 1, 98100, Messina, Italy;Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern- Kai 7, Frankfurt am Main, Germany;Department of Cardiovascular Imaging, King’s College London, Lambeth Wing, St. Thomas’ Hospital, London, UK;G. Monasterio CNR-Tuscany Foundation, Pisa, Italy;Department of Cardiovascular Imaging, King’s College London, Lambeth Wing, St. Thomas’ Hospital, London, UK;Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern- Kai 7, Frankfurt am Main, Germany;Department of Cardiology, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia;Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern- Kai 7, Frankfurt am Main, Germany;Department of Cardiology, National Cardiovascular Center Harapan Kita, Universitas Indonesia, Jakarta, Indonesia;Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern- Kai 7, Frankfurt am Main, Germany;Department of Cardiovascular Imaging, King’s College London, Lambeth Wing, St. Thomas’ Hospital, London, UK;Department of Cardiology, University Hospital Frankfurt, DZHK Rhein-Main, Theodor-Stern- Kai 7, Frankfurt am Main, Germany;

关键词: Cardiovascular magnetic resonance;    Gadobutrol;    Dose optimization;    Time optimization;   

DOI  :  10.1186/s12968-017-0400-4

 received in 2017-06-29, accepted in 2017-10-16,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundReducing time and contrast agent doses are important goals to provide cost-efficient cardiovascular magnetic resonance (CMR) imaging. Limited information is available regarding the feasibility of evaluating left ventricular (LV) function after gadobutrol injection as well as defining the lowest dose for high quality scar imaging. We sought to evaluate both aspects separately and systematically to provide an optimized protocol for contrast-enhanced CMR (CE-CMR) using gadobutrol.MethodsThis is a prospective, randomized, single-blind cross-over study performed in two different populations. The first population consisted of 30 patients with general indications for a rest CE-CMR who underwent cine-imaging before and immediately after intravenous administration of 0.1 mmol/kg body-weight of gadobutrol. Quantitative assessment of LV volumes and function was performed by the same reader in a randomized and blinded fashion. The second population was composed of 30 patients with indication to late gadolinium enhancement (LGE) imaging, which was performed twice at different gadobutrol doses (0.1 mmol/kg vs. 0.2 mmol/kg) and at different time delays (5 and 10 min vs. 5, 10, 15 and 20 min), within a maximal interval of 21 days. LGE images were analysed qualitatively (contrast-to-noise ratio) and quantitatively (LGE%-of-mass).ResultsExcellent correlation between pre- and post-contrast cine-imaging was found, with no difference of LV stroke volume and ejection fraction (p = 0.538 and p = 0.095, respectively). End-diastolic-volume and end-systolic-volume were measured significantly larger after contrast injection (p = 0.008 and p = 0.001, respectively), with a mean difference of 3.7 ml and 2.9 ml, respectively. LGE imaging resulted in optimal contrast-to-noise ratios 10 min post-injection for a gadobutrol dose of 0.1 mmol/kg body-weight and 20 min for a dose of 0.2 mmol/kg body-weight. At these time points LGE quantification did not significantly differ (0.1 mmol/kg: 11% (16.4); 0.2 mmol/kg: 12% (14.5); p = 0.059), showing excellent correlation (ICC = 0.957; p < 0.001).ConclusionA standardized CE-CMR rest protocol giving a dose of 0.1 mmol/kg of gadobutrol before cine-imaging and performing LGE 10 min after injection represents a fast low-dose protocol without significant loss of information in comparison to a longer protocol with cine-imaging before contrast injection and a higher dose of gadobutrol. This approach allows to reduce examination time and costs as well as minimize contrast-agent exposure.

【 授权许可】

CC BY   
© The Author(s). 2017